Psychiatric Factors Associated with Farmers' Syndrome

농부중의 정신적 원인에 대한 연구

Backgrounds : There has been many studies investigating the causes of farmers' syndrome. In some studies, psychologic stress is related to farmer's syndrome. And the diagnostic criteria of farmer's syndrome is similar to those of generalized anxiety disorder. So we carried out this study to investigate the psychiatric causes of farmers' syndrome. Methods : This study was done in some rural and urban areas of Kyoungsangnam Province, July, August, October and November of 1996. Those who came to free medical service and completed interview, medical examination and laboratory examination and 20-59 years old were 150 persons. And those who came to health center for health examination and completed only interview and 20-59 years old were 94 persons. The questionnaire was composed of sociodemographic factors, health risk factors, farmer's syndrome, work load, BEPSI(inventory to measure stress), Spielberger's state-trait anxiety inventory, self-rating depression scale. To examine statistical significance, we used X2-test, Mantel-Haenszel test for linear association, t-test, ANCOVA, correlation, multiple regression, logistic regression. Results : The prevalence of farmer's syndrome, adjusted for age and sex with population of Kyungsangnam Province of 1993 was 208 per 1,000(90 per 1,000 in men and 329 per 1,000 in women). In bivariate analysis, farmer's syndrome was significantly related to age, sex, job, income, smoking, alcohol drinking, work load, BEPSI, state anxiety, trait anxiety, depression, body mass index, Hwa-Byung, hypertension, anemia. However, when age and sex were adjusted, job was not significantly related to farmer's syndrome. The score of farmer's syndrome was significantly related to age, sex, work load, BEPSI, trait anxiety by multiple regression. Farmer's syndrome was significantly related to increasing age(odd ratio 1.079, 95% C.I. 1.060 - 1.099), sex(odds ratio of male 0.434, 95% C.I. 0.349 - 0.540), and BEPSI(odds ratio 1.231, 95% C.I. 1.148 - 1.320) by logistic regression. Results of logistic regression analysis of the component symptoms of farmer's syndrome were as follows. Shoulder stiffness was significantly related to increasing age, female sex and BEPSI. Lumbago was significantly related to increasing age, female sex and trait anxiety. Numb limbs and nocturia was significantly related to increasing age and female sex. Breathlessness was significantly related to work load, sleeplessness was significantly related to depression, dizziness was significantly related to job and state anxiety, and abdominal fullness was significantly related to female sex. Conclusion : Farmers' syndrome was related to work load, but was more related to psychiatric factors such as BEPSI and trait anxiety. And the occupation was not risk factor of farmers' syndrome in this study, so further study is needed to investigate the cause of farmers' syndrome.